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Published on: December 19, 2020
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[A case of COVID-19 associated ischemic colitis]
Xin Liu1, Xueying Shi2, Jun Li1
1Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China.
Summary
COVID-19 can cause ischemic colitis, even in moderate cases, presenting with widespread intestinal lesions. This case highlights the link between coronavirus infection-induced hypercoagulability and atypical ischemic colitis presentation.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pathology
Background:
- Ischemic colitis involves intestinal tissue death due to reduced blood supply, with risk factors including cardiovascular disease and diabetes.
- Typical symptoms are abdominal pain and hematochezia, often affecting the splenic flexure and rectosigmoid junction.
Observation:
- A moderate COVID-19 patient presented with atypical ischemic colitis, featuring diffuse lesions from cecum to rectosigmoid junction.
- Imaging showed no signs of intestinal ischemia, but pathology revealed thrombosis in small interstitial vessels.
- The patient had no significant prior risk factors, but exhibited elevated ferritin and D-dimer levels.
Findings:
- The study suggests that hypercoagulability, potentially induced by SARS-CoV-2 infection, played a role in the development of ischemic colitis in this patient.
- This case demonstrates an unusual presentation of ischemic colitis with extensive lesions and a slow recovery course.
Implications:
- Clinicians should consider ischemic colitis in COVID-19 patients experiencing abdominal pain and hematochezia, even in non-severe cases.
- Early recognition and management are crucial, as this condition can be mistaken for general gastrointestinal symptoms of COVID-19.
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